I'd like some clarity on what you mean by "schizoid". Do you mean "schizo," as schizoid personality disorder is entirely different from schizophrenia..? In any case, this is the sort of language (OMG i'm so OCD!!, etc.) that adds to the stigma around mental health issues. As a medical professional I'm sure you work with people with mental health issues.
Sorry you're disappointed but thanks for engaging. I'm using schizoid as an adjective - meaning to describe an attitude or behaviour "having mutually contradictory or antagonistic parts : changing frequently between opposite states" (Merriam Webster). Not as a noun referring to the personality disorder (which came later). SImilar examples would be using Narcisistic or Histrionic or even Obsessive Compulsive as adjectives to describe behavior, not as a reference to the clinical personality disorder. It's tough to police language around personality disorders because their terminology uses descriptions of "normal" behavior that when taken to an extreme becomes dysfunctional - as a result the words have lots of other uses in the language that predate their use in psychiatry...
Hope that helps clear things up and rest assured that I am very anti-stigma when it comes to mental or any other health issues.
Almost everyone in my sphere has finally had Covid, most only in the past year because I guess I hang with a lot of maskers and vaxxers. For most folks it came and went without much fanfare. I agree that our health policies need to factor in the vast majority of cases now that morbidity is low. But health policy and heath care are two different things. I’ve seen close up how heath care has moved on from Covid as my wife has been felled by mysterious neuropathy for months with pain that started on her third day — Covid that came from a cousin who came to visit with full knowledge she had it. Notable that two doctors declined to give my wife Paxlovid on days 1 and 2 of her illness this summer and a half dozen others have said, “Oh, sucks to be you” with no answers or solutions on the horizon. So here’s a voice for post-Covid sufferers and the loved ones who are picking up their pieces. They’re on the beach living large one day and pitiful shells of their former selfs after Covid. But not dead.
Totally agree that there's a LOT of work to be done understanding Long Covid, not least for how that knowledge will help us understand other post-viral syndromes as well.
"We also know that the sicker you are and the sicker you get both increase the risk of Long Covid. Reassuringly - and this corresponds with my clinical experience - Long Covid appears to wane over time. Beyond all that, Long Covid largely remains a black box." I am reasonably in agreement with your arguments overall, but can't help commentating, that in a lot of cases (and no I can't put an exact number to it, but we are members of several online Long Covid groups and see what goes on there) Long Covid does NOT seem to wane over time. Unfortunately my wife and I have direct personal experience of this - we've both had Long Covid for 3.5 years with no sign of it waning. We were also unlucky to get reinfected after visiting friends a month ago - their daughter tested positive the following morning. We have tried to be careful, but it happened. Now a month later my LC symptoms are really bad - I'm sleeping 16 hours a day and feel lousy. So the phrase"appears to wane over time" needs qualification. I also saw a study which concluded that for 80% of people with LC their symptoms worsen after re-infection. Believe me, I'd like to feel there is a strong reason to hope - but I don't see one.
Hi Francis - I'm sorry for what you and your wife are going through. I'm not an expert on LC but for experts I have talked to all tell me the data is weak or mixed - and far beyond the scope of this post. The main point I was trying to get across is that wherever you stand on LC, normalizing it (and covidizing other viruses) is what we should move to in order to reduce its spread,
Yes, agree that the data is not fully conclusive - nobody has done a fully definitive study on this to my knowledge - but for example, Gez Medinger, who's a journalist who has been a very useful contributor for people with LC , has continuously interviewed a lot of experts, and carried out several surveys. He provides caveats that they are not perfect, but I think they are worth looking at and considering, and they provide useful indications. He carried out surveys in 2020, and 2 years later - this second one found that - yes, 40% of LC patients had improved in the previous six months, however 28% had got worse and 30% were the same - only 9% said they had completely recovered - which means that 58% of people didn't improve. Look, I want to have hope for the future - but I also personally don't find it useful when I feel that the impact is being minimised or not accurately portrayed. My wife and I continually read up the research and we have tried many different approaches to treatment - while studying what many other researchers say as well. In short, there is no doubt there are large numbers of people who have not improved since they developed LC.
I'd like some clarity on what you mean by "schizoid". Do you mean "schizo," as schizoid personality disorder is entirely different from schizophrenia..? In any case, this is the sort of language (OMG i'm so OCD!!, etc.) that adds to the stigma around mental health issues. As a medical professional I'm sure you work with people with mental health issues.
Sorry you're disappointed but thanks for engaging. I'm using schizoid as an adjective - meaning to describe an attitude or behaviour "having mutually contradictory or antagonistic parts : changing frequently between opposite states" (Merriam Webster). Not as a noun referring to the personality disorder (which came later). SImilar examples would be using Narcisistic or Histrionic or even Obsessive Compulsive as adjectives to describe behavior, not as a reference to the clinical personality disorder. It's tough to police language around personality disorders because their terminology uses descriptions of "normal" behavior that when taken to an extreme becomes dysfunctional - as a result the words have lots of other uses in the language that predate their use in psychiatry...
Hope that helps clear things up and rest assured that I am very anti-stigma when it comes to mental or any other health issues.
Almost everyone in my sphere has finally had Covid, most only in the past year because I guess I hang with a lot of maskers and vaxxers. For most folks it came and went without much fanfare. I agree that our health policies need to factor in the vast majority of cases now that morbidity is low. But health policy and heath care are two different things. I’ve seen close up how heath care has moved on from Covid as my wife has been felled by mysterious neuropathy for months with pain that started on her third day — Covid that came from a cousin who came to visit with full knowledge she had it. Notable that two doctors declined to give my wife Paxlovid on days 1 and 2 of her illness this summer and a half dozen others have said, “Oh, sucks to be you” with no answers or solutions on the horizon. So here’s a voice for post-Covid sufferers and the loved ones who are picking up their pieces. They’re on the beach living large one day and pitiful shells of their former selfs after Covid. But not dead.
Totally agree that there's a LOT of work to be done understanding Long Covid, not least for how that knowledge will help us understand other post-viral syndromes as well.
"We also know that the sicker you are and the sicker you get both increase the risk of Long Covid. Reassuringly - and this corresponds with my clinical experience - Long Covid appears to wane over time. Beyond all that, Long Covid largely remains a black box." I am reasonably in agreement with your arguments overall, but can't help commentating, that in a lot of cases (and no I can't put an exact number to it, but we are members of several online Long Covid groups and see what goes on there) Long Covid does NOT seem to wane over time. Unfortunately my wife and I have direct personal experience of this - we've both had Long Covid for 3.5 years with no sign of it waning. We were also unlucky to get reinfected after visiting friends a month ago - their daughter tested positive the following morning. We have tried to be careful, but it happened. Now a month later my LC symptoms are really bad - I'm sleeping 16 hours a day and feel lousy. So the phrase"appears to wane over time" needs qualification. I also saw a study which concluded that for 80% of people with LC their symptoms worsen after re-infection. Believe me, I'd like to feel there is a strong reason to hope - but I don't see one.
Hi Francis - I'm sorry for what you and your wife are going through. I'm not an expert on LC but for experts I have talked to all tell me the data is weak or mixed - and far beyond the scope of this post. The main point I was trying to get across is that wherever you stand on LC, normalizing it (and covidizing other viruses) is what we should move to in order to reduce its spread,
Yes, agree that the data is not fully conclusive - nobody has done a fully definitive study on this to my knowledge - but for example, Gez Medinger, who's a journalist who has been a very useful contributor for people with LC , has continuously interviewed a lot of experts, and carried out several surveys. He provides caveats that they are not perfect, but I think they are worth looking at and considering, and they provide useful indications. He carried out surveys in 2020, and 2 years later - this second one found that - yes, 40% of LC patients had improved in the previous six months, however 28% had got worse and 30% were the same - only 9% said they had completely recovered - which means that 58% of people didn't improve. Look, I want to have hope for the future - but I also personally don't find it useful when I feel that the impact is being minimised or not accurately portrayed. My wife and I continually read up the research and we have tried many different approaches to treatment - while studying what many other researchers say as well. In short, there is no doubt there are large numbers of people who have not improved since they developed LC.
Nice photo composition
Thanks Michael - I agree - my daughter has a good eye!
Thank you for this article, Dr Bregman
Thanks for reading it Arthene!
Love.
Love your post!!
Great read Doc!!!
Thanks Bill!
i woke up to this article, and i thank you for it. hoping that this is the path forward.
gmar chatima tova and a healthy and happy new year.
Thank you Deborah - gmar chatima tova to you as well!